The National Trauma Data Bank Report for 2004 describes 576,247 hospital admissions for trauma between 1999 and 2004. Of these cases, 109,080 patients were admitted to the intensive care unit (ICU), 100,050 were taken directly to the operating room (OR), and 7878 died. The remaining 332,928 were admitted for general care. For many of these patients (especially for the ICU and OR patients) it was necessary to closely monitor the hematocrit with multiple phlebotomy blood samples within the first few hours. The key to providing optimal care for these challenging patients is for the trauma specialist to provide rapid therapeutic interventions based upon informed decision-making. The clinician's ability to deliver such quality care is based primarily on physical assessment skills, training, and experience, and secondly upon the degree of patient physiologic and hemodynamic data available at the moment of decision-making. There is a clear need for the clinician to have quantitative data to base his or her treatment decision.
The process of frequent phlebotomy consumes valuable emergency staff time and there can be substantial lag-time before results are available. Laboratory techniques have become more accurate and bedside devices have improved turn-around time for in vitro lab analysis, but these improvements have not alleviated the central problem of lack of real time information. The patient's condition may deteriorate within minutes, and reasons for the deterioration can be varied and not always obvious. Survival rates for such patients could be improved if needed data could be provided continuously, allowing better opportunity to act upon the vital information in a more timely manner. Patient monitoring methods have advanced over the decades with the development continuous arterial blood and oximetry pressure monitoring, but there remains no device that delivers other necessary physiologic data on a continuous basis. New Paradigm Concepts (NPC) proposes to remove uncertainty in realm of critical care medicine by developing a point-of-care continuous blood concentration monitor.
In the current practice of critical care medicine, the only patient parameters that are continuously monitored are the vital signs, pulse oximetry, and temperature. Aside from oximetry, the physiologic parameters are available only through phlebotomy sampling and laboratory analysis. The hemodynamic parameters, other than vital signs, are available only with central vascular catheterization in the ICU or the cardiac catheter laboratory. The availability of these continuous physiologic and hemodynamic parameters during patient resuscitation would improve the delivery of appropriate, timely, and cost effective patient care and, thereby, improve outcomes. Such continuous monitoring would also improve the ability of the critical care team to effectively care for multiple patients without the need for numerous and laborious repeat lab tests.